Gray Mandi, Wessel Samara, Oster Richard T, Bruno Grant, Healy Chyloe, Rich Rebecca, Scott Claringbold Shayla, Williams Kienan, Henderson Rita
Post-Doctoral Associate, Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Health System Impact Fellow, Indigenous Wellness Core, Alberta Health Services, Calgary, Alberta, Canada.
J Health Serv Res Policy. 2025 Apr;30(2):117-126. doi: 10.1177/13558196241300856. Epub 2024 Nov 28.
The lack of Indigenous health care data in Canada makes it challenging to plan health care services and inform Indigenous leadership on the health care needs of their respective Nations and communities. Several Canadian health care organizations have implemented a voluntary Indigenous identifier of patients within their electronic medical records. This study examines facilitators and barriers to implementing such a voluntary self-reported Indigenous identifier, from the perspective of key stakeholders who work at four Canadian health providers where an Indigenous identifier has been implemented.
The four Canadian sites comprise three hospitals and one health authority. At each site, key stakeholders participated in semi-structured qualitative interviews. Interviews were transcribed and coded. Relevant documents that were publicly available or provided by each site were reviewed.
There were four primary findings. First, for the introduction of an Indigenous identifier to be successful there must be pre-existing strong and trusting relationships between Indigenous communities and health care organizations. Second, health care organizations must provide training for those who ask clientele to self-identify as Indigenous, to overcome issues such as any patient backlash. Third, for the relationship between Indigenous people and health organizations to flourish, data governance must be Indigenous-led. Finally, the collection of Indigenous identifier data can enhance Indigenous health care services and health care service planning and delivery.
Due to the ongoing distrust of government and health care services among Indigenous peoples and communities, special considerations are required prior to the implementation of an Indigenous identifier. Of primary importance is how health care organizations can contribute to Indigenous data governance and minimize potential harms associated with the collection of such data. The findings of this study can be used to guide other health care sites and Indigenous leaders aspiring for more robust health data by implementing voluntary Indigenous identity data collection.
加拿大缺乏原住民医疗保健数据，这给规划医疗保健服务以及向原住民领导层通报其各自民族和社区的医疗保健需求带来了挑战。加拿大的几家医疗保健组织已在其电子病历中实施了患者自愿性原住民标识符。本研究从在四家已实施原住民标识符的加拿大医疗服务提供者处工作的关键利益相关者的角度，审视实施这种自愿自我报告的原住民标识符的促进因素和障碍。
加拿大的这四个地点包括三家医院和一个卫生当局。在每个地点，关键利益相关者参与了半结构化定性访谈。访谈内容被转录并编码。对每个地点公开提供或提供的相关文件进行了审查。
有四个主要发现。首先，要成功引入原住民标识符，原住民社区和医疗保健组织之间必须预先存在牢固且相互信任的关系。其次，医疗保健组织必须为那些要求客户自我识别为原住民的人员提供培训，以克服诸如患者抵触等问题。第三，为了使原住民与卫生组织之间的关系蓬勃发展，数据治理必须由原住民主导。最后，收集原住民标识符数据可以加强原住民医疗保健服务以及医疗保健服务的规划和提供。
由于原住民和社区对政府及医疗保健服务一直存在不信任，在实施原住民标识符之前需要进行特殊考虑。最重要的是医疗保健组织如何能够为原住民数据治理做出贡献，并将与此类数据收集相关的潜在危害降至最低。本研究的结果可用于指导其他医疗保健机构以及渴望通过实施自愿性原住民身份数据收集来获取更全面医疗数据的原住民领导人。
